Current updates and future directions in diagnosis and management of gastroenteropancreatic neuroendocrine neoplasms

doi:10.4253/wjge.v14.i5.267

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May 16, 2022 (publication date) through Feb 18, 2025

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World Journal of Gastrointestinal Endoscopy

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1948-5190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Endosc. May 16, 2022; 14(5): 267-290
Published online May 16, 2022. doi: 10.4253/wjge.v14.i5.267

Table 6 Diagnosing pancreatic neuroendocrine tumors[136,174]

	Diagnostic evaluation
All pancreatic NET	Multiphasic CT/MRI
All pancreatic NET	If results impact management, gallium DOTATATE PET CTEUS with biopsy
Insulinoma	72 h fast test: Hypoglycemia with elevated insulin
Insulinoma	Oral glucose tolerance test: May be necessary in minority with only postprandial hypoglycemia
Gastrinoma	Fasting gastrin 10 times upper limit of normal + gastric pH < 2
	If gastrin less elevated + gastric pH < 2, measure BAO with secretin test
	BAO > 15 mEq/h or serum gastrin increase > 120 pg/mL
Glucagonoma	Fasting serum glucagon > 500 pg/mL
Somatostatinoma	Fasting plasma somatostatin > 30 pg/mL
VIPoma	Large volume diarrhea + serum VIP > 75 pg/mL

NET: Neuroendocrine tumor; CT: Computed tomography; MRI: Magnetic resonance imaging; PET: Positron emission tomography; EUS: Endoscopic ultrasound; BAO: Basal acid output.

Citation: Canakis A, Lee LS. Current updates and future directions in diagnosis and management of gastroenteropancreatic neuroendocrine neoplasms. World J Gastrointest Endosc 2022; 14(5): 267-290
URL: https://www.wjgnet.com/1948-5190/full/v14/i5/267.htm
DOI: https://dx.doi.org/10.4253/wjge.v14.i5.267